The decline in visual acuity in elderly people with healthy eyes or eyes with early age-related maculopathy in two Scandinavian population samples

Abstract

This study aimed to analyse the decline in visual acuity (VA) during normal ageing in two Scandinavian population samples of subjects aged ≥ 70 years and to study the age-specific decline in VA in eyes with early age-related maculopathy (ARM). We carried out a cross-sectional analysis of data pertaining to VA in the better eye in one population sample from Oulu (OU), Finland (aged 70-82 years) and a second population sample from Gothenburg (GG), Sweden (aged 82 or 88 years). The change in VA with age was evaluated in healthy eyes (OU, n = 119; GG, n = 40) and in eyes with early ARM (OU-ARM, n = 22; GG-ARM, n = 114) using linear regression or logistic regression. The results were compared with those of previous reports. Our population samples showed a significant decrease with age in VA in healthy eyes in subjects aged ≥ 44 years using both statistical models. Comparisons with previous reports demonstrated a homogeneity in the decline in VA with age. On average, 0.3 logMAR are lost from middle age up to 88 years, presumably as a result of physiological ageing. In early ARM, the rate of age-specific decline in VA more than doubled and the prevalence of VA < 0.5 markedly increased. Visual acuity in healthy eyes declines with age from middle age onwards. The decrease in VA possibly accelerates in subjects aged > 70 years, although no significant evidence for this was found. An age-specific decline in VA is shown in eyes with early ARM. These results are important for the evaluation of age-specific treatment results.